The increased use of telehealth is one of the few good things to come from the pandemic. Telehealth has enabled thousands of patients across the country to access their doctor from the comfort and safety of their own homes. And for providers, the use of telehealth has enabled them to safely serve even more patients.
All good things. But apparently in NC, all good things must come to an end.
According to an April 4th article in NC Health News, North Carolina Medicaid will no longer cover occupational (OT) and physical (PT) therapy services conducted via telehealth, beginning July 1.
This is a major blow for patients. Telehealth has increased access for people who can’t afford transportation to and from a clinic, as well as those who don’t have any transportation to begin with. In NC alone, nearly 60,000 telehealth claims from individuals on Medicaid were recorded in the first few months of COVID-19.
For PT and OT patients, telehealth has not only helped with accessibility, but also with consistency. According to the article, telehealth settings have led to fewer cancellations and “no-shows.” It’s also allowed patients to incorporate their exercises more easily into their daily routines, and it enables therapists to see in real-time the environments in which their patients can progress in treatment.
While the state’s OT association seems to support telehealth’s continuation, the end of coverage appears imminent. The federal Centers for Medicare & Medicaid Services (CMS) is not allowing permanent changes to Medicaid programs, and the state Medicaid office doesn’t appear to be advocating for a continuation, according to the article.
While the reduction in coverage currently applies only to patients with Medicaid coverage, people with private insurance plans might find their coverage is up next on the chopping block.
“Private insurance plans often follow what Medicaid does, meaning there’s a good chance that if telehealth for OT and PT is made permanent by the federally funded health care program, other insurance plans may follow,” the article stated.
And if you’re waiting on private plans to recognize the benefit to patients and make a different coverage choice, don’t hold your breath. Reduced coverage means reduced claims and higher costs for consumers – and increased profits for health plans. So we know where we’re placing our bets.